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Nitrous oxide dosage

Guideline on Use of Nitrous Oxide for the Pediatric Dental Patients

-Nitrous oxide is a colorless and virtually odorless gas with a faint, sweet smell.
-It is an effective analgesic/anxiolytic agent causing central nervous system (CNS) depression and euphoria with little effect on the respiratory system.
-Nitrous oxide is absorbed rapidly, allowing for both rapid onset and recovery (two to three minutes)
-It exhibits a superior safety profile with no recorded fatalities or cases of serious morbidity
-Objectives of nitrous oxide inhalation include reducing anxiety, increasing cooperation, raising the pain threshold, increasing tolerance for longer appointment, and reduce gagging
-Disadvantages include lack of potency and the patient must be able to breathe through their nose
-Contraindications to nitrous oxide administration include COPD, severe emotional disturbances/drug related dependencies, first trimester of pregnancy, treatment with blemycin sulfate, methylenetetrahydrofolate reductase deficiency, and cobalamin deficiency
-A flow rate of five to six L/min generally is acceptable to most patients. The flow rate can be adjusted after observation of the reservoir bag. The bag should pulsate gently with each breath and should not be either over- or underinflated.
-Introduction of 100 percent oxygen for one to two minutes followed by titration of nitrous oxide in 10 percent intervals is recommended.
- Nitrous oxide concentration may be decreased during easier procedures (eg, restorations) and increased during more stimulating ones (eg, extraction, injection of local anesthetic).
-Side effects such as nausea and vomiting are more likely to be observed when titration is not employed.
-During nitrous oxide/ oxygen analgesia/anxiolysis, continual clinical observation of the patient’s responsiveness, color, and respiratory rate and rhythm must be performed
-Nausea and vomiting are the most common adverse effects, occurring in 0.5 percent of patients.
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Brady Worldwide, Inc. Brady 87746 2-3/4" Width x 2-1/4" Height, B-946 High Performance Vinyl, White on Blue Medical Gas Pipe Marker, Legend "Nitrous Oxide"
BISS (Brady Worldwide, Inc.)
  • Used for pipemarkers, arrow tape, numbers and letters, vehicle placards, pedestal markers, warning panels and safety signs
  • Brady B-946 is printed with weather resistant inks and is particularly suited for use in outdoor applications where weatherability is a key consideration
  • Adhesive Type: Permanent cold temperature pressure sensitive acrylic
  • Service temperature: -40 degree F to 180 degree F
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